Discussion on the Assessment of the State of Nutrition

Abstract

FOR profitable discussion of any subject there must first of all be agreement as to the defining terms. Nowhere is this so necessary as in respect of nutrition and malnutrition. These subjects, perhaps more than any others of medical interest, are to-day suffering from the vagueness of expression which is the inevitable result of too rapid attraction of public attention.Nutrition is concerned with the supply of food, its composition, preparation, taste, and suitability to meet the requirements of the body in different physiological states and environmental conditions. This division of nutrition is dietetics or the science of food. In its purely physiological aspect nutrition includes what is known about the history of foodstuffs in the body, that-is, about the different processes which come under the headings of digestion, absorption, metabolism, and excretion. Each of these divisions is a subject in itself, and if we are to obtain a proper conception of nutrition as a whole, we must not lose sight of the fact that the different functions with which they deal blend harmoniously in the healthy body. It is important also to bear in mind the common purpose of the activities of every cell in the body, viz., the preservation of the life and health of the individual and the perpetuation of the species. Towards these ends all the systems and organs of the body operate in concerted harmony. Disharmony in the relationship resulting from an upset in one system reacts adversely on all the other functions of the body. Disease of the circulatory, respiratory, nervous, or endocrine system will have harmful effects on the nutritional processes and vice versa, with this difference, however, that nutrition and respiration are more fundamental for life than the functions of any of the other systems. The effects of disordered nutrition or malnutrition, therefore, extend to every function of the body.Malnutrition presents its greatest problems in child welfare and school clinics, and it is therefore to children, and especially to school children, that the remarks which follow are intended to apply. " Malnutrition " is a word which occurs very frequently in current medical and non-medical publications, but knowledge of its meaning would appear to be in inverse ratio to its occurrence. One of the main reasons for the present confusion is the overlooking of the fact that the state of nutrition is dynamic and not static; APRIL-EPID. 1